ROADS I and II: Paving the way for healthier communities
The transport corridors of east, central and southern Africa are economic lifelines that link countries with their neighbors, serving as pathways for trade and engines to expand local economies. They are also major transmission routes for HIV. People working and living along these corridors — truck drivers, traders, businesspeople, employees of bars and lodgings, border and customs officers, and others — are at elevated risk of HIV infection. High unemployment and underemployment, multiple concurrent sexual partnerships, substance abuse, widespread gender-based violence and poor access to quality health services — including HIV prevention, care and treatment services — all fuel HIV transmission. Many corridor towns also lack sufficient services for family planning, reproductive health, nutrition, malaria, and maternal and child health.
Since 2005, the Regional Outreach Addressing AIDS through Development Strategies (ROADS) project, funded by the U.S. President's Emergency Plan for AIDS Relief through U.S. Agency for International Development (USAID) East Africa and bilateral missions, has linked communities along these transport corridors with critical HIV and other health services. ROADS is also helping individuals and communities reduce their vulnerability to HIV by expanding economic opportunities, improving food security, providing care and support for the most vulnerable children, and working to protect women and girls from sexual exploitation and abuse.
ROADS has strengthened community-based HIV and health programming in transport corridor communities, including border towns, across 11 African countries: Burundi, the Democratic Republic of the Congo, Djibouti, Ethiopia, Kenya, Mozambique, Rwanda, South Sudan, Tanzania, Uganda and Zambia.
The project uses an innovative community organizing approach — the cluster model — that brings together local volunteer groups with similar focus and interests (such as women, youth and people living with HIV). Cluster members jointly plan and implement activities that serve key segments of the community, reaching people through social networks where they live, work or go to school.
Through the locally driven cluster model, ROADS supports corridor communities in developing homegrown solutions for their self-identified health and development challenges. From generating demand for HIV testing and counseling to enhancing food security and livelihoods for women, ROADS provides integrated solutions to meet the health, economic development and social needs of those who need them the most.
ROADS currently reaches approximately 6.5 million people, including 300,000 truck drivers. More than 1,358 community-based organizations with approximately 110,590 members have been mobilized into 98 community clusters. ROADS collaborates closely with national AIDS control programs; government ministries; district health management teams; health facilities; and local, national and international private-sector companies.
ROADS has established close links with public health systems, as well as health providers, to strengthen and improve access to services, including services related to HIV, family planning, reproductive health, nutrition, malaria, and maternal and child health. For mobile men — a hard-to-reach audience — the project supports a network of branded, alcohol-free, SafeTStop Resource Centers at strategic stopover points. The centers are open at convenient hours and offer health education, HIV testing and counseling, condom distribution, diagnosis and treatment of sexually transmitted infections, substance abuse counseling, and referral for clinical and community-based services. The centers also offer satellite television, movie screenings, billiards and other recreational activities to draw men away from risky settings.
Economic development and nutrition
The project's economic strengthening component expands livelihoods and boosts household economic resilience by providing training and technical assistance in group savings and loans, microenterprise development and modern agricultural skills, such as livestock management, urban and organic gardening and more.
Children and youth
ROADS strengthens the capacity of families and communities to meet the multiple needs of the most vulnerable children over the long term. This includes strengthening referral linkages among diverse social welfare providers and focusing on the needs of older children, including those heading households and those transitioning to young adulthood.
ROADS advances the status of women through initiatives that promote women's health, create opportunities for leadership and livelihoods, and help protect women from violence and exploitation. Across the region, community-led, multi-sectoral task forces address gender-based violence as a barrier to uptake of HIV, family planning and other health services. And women are applying skills they acquired through ROADS in positions of local and national leadership. In Rwanda, women who have participated in project-supported entrepreneurial activities are using their increased income to purchase health insurance, refurbish their houses, employ other community members and reduce their reliance on high-risk survival strategies. In Mozambique, 16 men’s groups, mainly small-business associations, were formed to promote positive male behavior, including routine HIV testing and counseling, reduction in the number of sexual partners, increased condom use, and decreased drug and alcohol consumption.
FHI 360 leads implementation of the ROADS project. Strategic partners include DAI, Howard University/Pharmacists and Continuing Education, Jhpiego, Johns Hopkins University/Center for Communication Programs, North Star Alliance, PATH and Voice for Humanity.
In countries across east, central and southern Africa, ROADS is transforming corridors of risk into pathways of prevention and hope.